They may yield clues about the contribution of environmental factors to the disease etiology, or at least, provide important information about its behavior, enabling the identification of the geographical areas that should be further investigated by policy makers and healthcare insurers The conduction of epidemiologic studies on IBD can be particularly difficult due to the onset of the disease may be gradual, and medical care may not be sought at once, making it hard to determine the agents that possibly acted at the beginning of the disease activity.
The lack of universally accepted criteria for IBD diagnosis, and the fact that the differential diagnosis is broad, including intestinal infections, intestinal infestations and functional diseases frequently found in the population of many countries, can lead to misdiagnosis.
Also, comparing the incidence and prevalence rates of this diseases in different areas is not easy and of difficult epidemiological interpretation. The currently available epidemiological data of intestinal inflammatory diseases show that these diseases are more frequent in industrialized countries where incidence rates range from 6. On the other hand, in countries where industrial development is not so strong, IBD are less frequent with incidence and prevalence rates ranging from 0.
Today, IBD incidence is somewhat stable in areas where it was formerly high, and continuously rising where it used to be low Incidence and prevalence rates in Eastern European countries remain very low, but in Hungary and Croatia are as high as in Western Europe.
Furthermore, UC predominance is diminishing as CD is becoming more prevalent. In addition, IBD are more common in young people, with women slightly more likely to develop CD while men are more likely to develop UC 4, In Central and South America, epidemiologic data on IBD are still scarce, demonstrating the rarity of these diseases or their insufficient registries in these appraised areas 1, 6, Nonetheless, a tendency toward increase, mainly of CD has been reported in Puerto Rico 1.
In Brazil, few are the studies regarding the epidemiologic aspects of IBD. Most of them just describe clinic IBD characteristics and the frequency of hospital admission due to IBD, with no reference to the incidence and prevalence of these diseases in population terms.
In brief, IBD frequency rates have constantly changed worldwide. The causes of the continuous and rapid changes in IBD incidence are still unknown, but there are evidence to support the possible sharing of environmental factors such as dietary habits, lifestyle and other factors associated to industrial development. The initial step to understand the real medical importance of IBD is to determine its incidence and prevalence rates in most areas of a country.
The IBD cases coming from exclusively from the studied region were sequentially identified from to by the medical records from the hospital, and putted together in a database created for this purpose at the Intestinal Inflammatory Diseases at University Hospital of Botucatu School of Medicine - UNESP - a referral medical center for the 30 municipal districts that compose the study region.
The patient inclusion criteria in study was: patients adults over 15 years of age , male or female with IBD, living in area urban or rural located in the study area attended during a year period to Were excluded all other patients with IBD attended in this Hospital that are not living in this target region. No centralized IBD database were available in the study area, also was necessary the construction of a database based on inpatient and outpatient reports for patients residing in this study area for the conduction of this epidemiologic investigation.
Epidemiological data age, reported race, gender and residence were extracted from the hospital database containing the registry of patients with IBD living on the target region. Male, female and total population of the middle year of each period was used as standard to compute the incidence and prevalence rates of IBD for that period into which the patients were grouped.
The annual adult male, female and total populations were estimated based on data published by the Brazilian Institute of Geography and Statistics Descriptive and inferential analyses of the distribution of patients with IBD according to race and residence were performed using the proportion test Differences among proportions in all the tests were considered significant when P d" 0, The Poisson regression model 4, 20 was used to find the best adjustment of linear equations for the parameters gender and time of entrance of patients in study considering total IBD, UC, CD and NCC in overall intervals studied.
The Akaike Information Criterion AIC was used to check the adjustment levels of linear regression equation models for nonaligned alternatives 4. The smallest AIC provided the best linear equation model. Software used: SPSS vs. The majority of the IBD patients, in the study area, was white and lived in urban districts Table 1. IBD patients were aged between 15 to 74 years, with a mean age of So, the incidence of UC was significantly higher than that of CD, which in turn was significantly higher than NCC incidence in all periods.
Between and , the prevalence rates of UC, CD and NCC in the entire studied population increased more in the first 2 intervals than in the last one Figure 4. The medical services in the study area have been limited regarding IBD management. In this service, IBD patients are attended by a specialized group of gastroenterologists, nutritionists and psychologists.
The attendance of the group is weekly and a follow up visit is obligatory every 6 months for all patients in remission of disease. In the event of an acute crisis, the patient is guided to the Hospital service, as soon as possible, in any time. A study based on Medicare beneficiaries aged 66 years or older found that older adults with IBD were more likely to be hospitalized for hip fractures and have day readmissions and longer hospital stays.
In addition, clinicians should be aware of potential health-risk behaviors that are more prevalent among adults with IBD than those without, 7 such as:. Since IBD is associated with various chronic and infectious conditions, preventive care is an essential aspect of lifelong disease management. Besides receiving recommended preventive care, it is important to have a healthy and balanced diet.
A study assessing dietary patterns among adults with IBD from the National Health Interview Survey 14 found that adults with IBD were more likely to have low dietary fiber intake compared with adults without IBD; and women with IBD were more likely to have more sugar-sweetened beverages and total added sugar compared with women without IBD. Skip directly to site content Skip directly to page options Skip directly to A-Z link. Inflammatory bowel disease IBD.
Section Navigation. Facebook Twitter LinkedIn Syndicate. Data and Statistics. This means it is likely associated with the effects of multiple genes, in combination with lifestyle and environmental factors. However, if an autoimmune diseases such as Crohn's disease occurs in a family, it does not necessarily mean that relatives will develop an autoimmune disease.
Thus, having an affected family member is considered a risk factor for Crohn's disease. More than 30 distinct genes , or presumed locations of genes loci , have been suggested to be related to CD, including those related to susceptibility , age of onset, disease location, diagnosis, and prognosis. The NOD2 gene is currently the most replicated and understood. To view only a table from this article listing the genes that appear to be associated with Crohn's disease, click here.
Because the information provided here is complex, individuals seeking to better understand this information may benefit from meeting with a genetics professional or other qualified health care provider. References References. Crohn's disease. Diagnosing Crohn's Disease and Ulcerative Colitis.
Crohn Disease. Merck Manual Consumer Version. Crohn disease. Genetics Home Reference. What is Crohn's Disease?. Cummings S, Rubin D. Journal of Genetic Counseling. December ; What are complex or multifactorial disorders?. Department of Human Genetics. Autoimmune disorders. With more severe anaemia, the main symptoms are chronic ongoing tiredness and fatigue. You might also develop shortness of breath, headaches and general weakness.
How anaemia is treated will depend on its cause. For iron deficiency anaemia you may be prescribed iron supplements as tablets or as IV intravenous iron, which is given by injection or in an infusion through a drip.
Some people with IBD find that they cannot tolerate iron by mouth, so are given IV iron which can be more effective. For vitamin deficiency anaemia you may be given extra B12 or folic acid, as tablets or by injection. This is a different condition from IBD, although some of the symptoms are similar.
They may, for example, get diarrhoea even when their IBD is inactive. See Tests and Investigations for Crohn's and Colitis. You may need to have the tests repeated from time to time to check on your condition and how your treatment is working. Some drug treatments may also require a series of blood tests and, occasionally, x-rays or scans, to check for potential side effects.
However, your specialist will avoid giving you any unnecessary tests or investigations. This can mean that you need to take your medication on an on-going basis, sometimes for many years. The main types of drugs are:. Examples include mesalazine, olsalazine, sulphalazine and balsalazide. They include prednisolone, prednisone, methylprednisolone, budesonide, hydrocortisone, and beclometasone dipropionate.
You should always check with your IBD team before using them. For detailed information, see Other treatments for IBD. Some people with Crohn's or Colitis may be prescribed exclusive enteral nutrition a special liquid-only diet , usually for weeks. People on this diet do not eat ordinary food or drink because the liquid diet provides them with all the nutrients they need. Not everyone likes the taste of these specialised feeds, but they do come in a range of flavours.
Some people have found that taking the liquid ice-cold or through a straw makes it easier to drink. An alternative may be to take the feed overnight through a naso- gastric tube a fine tube passed through the nose down into the stomach.
It is commonly used in children because it can improve growth by providing easily digested nutrients. Adults are less likely to need exclusive enteral nutrition, but this can be an option for treating flares. Diets such as this are usually supervised by a dietitian. Some people may find it helpful to have supplemental drinks alongside normal food, in order to obtain more nutrients. This may also be useful for children. However, surgery remains an important and life-changing treatment option for many.
However, studies show for most people the actual risk is still relatively low. As many as a quarter of people with Crohn's or Colitis are diagnosed when under the age of sixteen.
But you can still get the most out of life. Health professionals can order some publications in bulk by using our online ordering system. If you would like a printed copy of a booklet or information sheet, please contact our helpline.
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